Expert and lay participation in the construction of medical knowledge

Abstract

This paper examines the explanatory value of Fleck's conceptual analysis with regard to the development of medical knowledge. The discussion is illustrated by empirical data gathered as part of an on-going study into Repetitive Strain Injury (RSI), a condition currently disputed within medical circles. Whilst there is empirical substantiation for some of Fleck's beliefs, the findings suggest his notion that general practitioners are educated and patients uneducated is too simplistic; in particular circumstances these attributes may be reversed. Furthermore, there is little evidence to show that ideas are circulated and exchanged between specialists, GPs and a lay audience; according to this revised view, medical knowledge is determined by experts alone. By invoking an extended version of Collins' notion of the 'core-set', the paper considers how seemingly marginal actors can exploit their technical competence and thus play an influential role in medical debate.

Developing Effective Crowdsourcing Systems for Medical Diagnosis: Challenges and Recommendations

“…This idea is consistent with the view from actor-network theory in sociology of scientific knowledge [15]. The theory proposes that facts are generated by networks of scientists and surrounding social groups [2].…”

“…Every element of knowledge has its roots in specific culture (tradition). There are, for example the Chinese culture, which in important fields such as medicine, arrived at quite different realities from western medicine [2]. The point is that, scientific knowledge is implicitly structured to be 'consistent with' wider cultural ideas; thus challenging commonly held beliefs of it being independent of such factors.…”

Everyday-ing Health Literacy and the Imperative of Health Communication: A Critical Agenda

“…Lay epidemiology is thus about how the society becomes a knowledge basis for possible community-based actions for enhancing health. The possible contribution of public knowledge in informing professional action has been documented in different works (Arksey 1994;Davison et al 1991). Essentially, it provides very important data about the possible cause of health risks (such as environmental risks).…”

Que saberes, em que diálogo(s), nas trajectórias de representação regulatória das associações de doentes?

“…As discussões correntes em torno de uma presuntiva lay expertise (Arksey, 1994), por exemplo, têm afinado a bitola do relevo dos saberes leigos pela sua crescente aproximação à matriz dos saberes periciais, assumindo os actores leigos nessa medida como pares capacitados para entrar em diálogo com a pericialidade. No entanto, o que os processos mais politizados de participação leiga em esferas deliberativas e decisórias em contextos de pesquisa científica, como no caso do HIV nos Estados Unidos da América (Epstein, 2000) e em França (Barbot, 2002), permitiram documentar, foi como o aprofundamento dessa lay expertise levou à crescente sensibilização dos actores leigosque por essa via foram socializados para a participação nas deliberações periciais -às perspectivas aí dominantes, distanciando-se das perspectivas de base para cuja defesa haviam sido ingressados em primeira instância.…”